Enhancing ophthalmic care: the role of multidose with preservative (MDWP)

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Enhancing ophthalmic care: the role of multidose with preservative (MDWP)

In ophthalmology, multidose with preservative (MDWP) eye drops remain a reliable, cost-effective and patient-friendly pharmaceutical solution. Designed to deliver multiple doses safely over time, these systems ensure medication sterility and efficacy thanks to preservatives that prevent microbial contamination.

By balancing safety, convenience and affordability, MDWP plays a key role in continuously improving ophthalmic care.

What is Multidose With Preservative (MDWP)?

Multidose with preservative packaging allows the administration of multiple doses from a single bottle, a critical requirement for many ophthalmic treatments such as eye drops. Preservatives protect the formulation against bacterial and fungal growth throughout the treatment period, ensuring safety, quality and efficacy until the last drop.

What are the key advantages of MDWP?

  • Extended shelf life: preservatives maintain product integrity and effectiveness during use.
  • Cost-effective solution: the multidose format reduces costs, waste and overall expenses compared to single-dose alternatives.
  • Patient convenience and adherence: easy-to-use devices support treatment adherence, particularly for chronic therapies.
  • Reduced environmental impact: fewer containers result in less plastic waste and a lower carbon footprint.

Applications of MDWP in ophthalmology

Multidose eye drops with preservatives are widely used across many ophthalmic indications, including:

  • Chronic conditions: glaucoma, dry eye disease and allergic conjunctivitis (beta-blockers, artificial tears and antihistamines).
  • Post-surgical care: antibiotics, corticosteroids and NSAIDs to prevent infection and control inflammation.
  • Ocular infections: antibacterial and anti-inflammatory treatments.
  • Diagnostic and therapeutic use: mydriatics and local anesthetics.
  • Contact lens care: cleaning and disinfecting solutions.

What challenges are associated with the use of preservatives?

Despite their benefits, preservatives used in ophthalmic products may cause ocular surface sensitivity or irritation in some patients, particularly during long-term treatments. To address these needs, preservative-free formulations and alternative delivery systems continue to be developed.

A systematic review published in the British Journal of Ophthalmology showed that benzalkonium chloride (BAK) remains present in approximately 70% of ophthalmic eye drops due to its broad antimicrobial efficacy and long shelf life. The review found no significant differences in adverse effects between BAK-preserved and preservative-free eye drops¹.

These findings highlight the importance of a careful and balanced selection of preservatives to ensure both therapeutic efficacy and patient comfort, particularly in chronic ophthalmic care.

Unither Pharmaceuticals CDMO services – Butantã site

Unither Pharmaceuticals offers comprehensive CDMO services, covering the development and industrial manufacturing of a wide range of ophthalmic pharmaceutical forms.

We also provide out-licensing dossiers to support regulatory submissions and accelerate market access. Currently available dossiers include carboxymethylcellulose sodium (CMC) formulations for MDWP in 10 mL and 15 mL multidose bottles, with sterile preserved solutions at 0.5% and 1%.

Advanced ophthalmic manufacturing capabilities at the Butantã site

To meet growing demand in the multidose market, Unither has invested in aseptic multidose filling capacity at its Butantã site in São Paulo, Brazil. With more than 70 million vials manufactured annually, the site is a recognized specialist in ophthalmology.

The acquisition of this facility in 2022 enables Unither to manufacture ophthalmic healthcare products across four continents: Europe, Asia, North America and South America.

Our capabilities include compounding, filling and packaging of solutions and suspensions in multidose containers with preservatives, with filling volumes ranging from 1.5 to 15 mL. We are specialized in ophthalmic and otology products and comply with international regulatory standards, including ANVISA, INVIMA, DIGEMID and DRAP.

Conclusion

Multidose containers with preservatives remain a cornerstone of ophthalmic drug delivery. They deliver key benefits in terms of shelf life, cost efficiency, patient convenience and environmental sustainability.

Through a global, patient-centric approach, Unither Pharmaceuticals integrates complementary technologies — Blow-Fill-Seal (BFS), multidose with preservatives and preservative-free multidose (PFMD) — to address diverse patient needs, regulatory requirements and international market expectations.

Reference: Hedengran A. et al. (2019). Efficacy and safety evaluation of benzalkonium chloride preserved eye-drops compared with alternatively preserved and preservative-free eye-drops in the treatment of glaucoma. British Journal of Ophthalmology. DOI: 10.1136/bjophthalmol-2019-315623